A condition affecting approximately 170 million adolescents and women worldwide has a new name – one that better reflects its complexity and far-reaching health impacts.
Polycystic ovary syndrome, PCOS, has long been understood as a reproductive disorder. But a paper published in The Lancet backed the proposal to rename it polyendocrine metabolic ovarian syndrome, PMOS, to more accurately capture what researchers now know about the condition: it is not just about the ovaries, but about the entire body.
“For decades, we have been referring to a syndrome that doesn’t fully represent the complexity of the condition,” said Heidi Vanden Brink, Ph.D., a reproductive physiologist and assistant professor in the Texas A&M Department of Nutrition and Texas A&M AgriLife Institute for Advancing Health Through Agriculture. “PMOS is about more than ovaries. Living with PMOS imparts significant reproductive, metabolic and psychological health implications.”
PMOS: More than a reproductive disorder
PMOS affects roughly one in eight women, making it one of the most common endocrine conditions globally. Up to 15% of Texas women – one in seven – have been diagnosed with the condition, which Vanden Brink said can often be misdiagnosed or go undiagnosed.
PMOS can cause male-pattern hair growth, severe acne, irregular menstruation and infertility.
A diagnosis is usually made based on the presence of at least two of three features, after exclusion of other conditions that could cause these symptoms. The three diagnostic features are irregular menstrual cycles, elevated testosterone levels or clinical signs of elevated testosterone, and either polycystic ovaries or elevated Anti-Mullerian Hormone, which is a hormone produced by structures called follicles in the ovaries.
The condition’s name has long been a source of confusion and frustration, Vanden Brink said. The term “polycystic ovaries,” represents only one of the three diagnostic features, which means you do not have to have polycystic ovaries to have PCOS or PMOS. And even the term “polycystic ovaries” has created confusion.
Polycystic ovaries in the context of PMOS means elevated numbers of small follicles, which are fluid filled sacs, in the ovaries – very different from the very large cysts many people imagine.
A whole-body health concern
Beyond reproductive symptoms, the condition is strongly linked to metabolic health, including higher risks of insulin resistance, Type 2 diabetes, cardiovascular disease and liver conditions. It can also affect mental health, contributing to anxiety, depression and reduced quality of life.
“These are not health concerns reflected in the current name,” Vanden Brink said. “When you hear ‘polycystic ovary syndrome,’ you think of the ovaries. But we’re also talking about metabolic health, psychological well-being and long-term disease risk.”
Melanie Cree, MD, Ph.D., professor of pediatrics-endocrinology and director of the multi-disciplinary PCOS clinic at the University of Colorado School of Medicine, Anschutz, is an author on The Lancet paper for the name change and a collaborator of Vanden Brink’s, who said recognizing the risks of PMOS beyond the ovaries and fertility are especially important when communicating preventative measures with teens and their parents.
“Adolescents have an increased risk for abnormal metabolic labs due to the effects of puberty in addition to PMOS,” Cree said. “Also, we don’t use ovary criteria for the diagnosis in teens. Thus, telling a girl and her family that she has PCOS, but we are not going to ultrasound the ovaries and instead are looking for metabolic conditions was very confusing. The new name better aligns with more of what patients may struggle with and also helps the understanding of why we often recommend therapies to treat metabolic conditions.”
Why a new name matters
The proposed name change to PMOS intends to address the gap in understanding among the public, but also health care providers and communication with patients, Vanden Brink said. By emphasizing endocrine and metabolic factors, researchers hope to improve awareness among both patients and providers and encourage more comprehensive care.
“The new name signals that PMOS is a condition that requires a multidisciplinary approach,” she said, noting that care often involves not only gynecologists, but also endocrinologists, dietitians and mental health professionals.
Improved understanding could also help address the major challenge: underdiagnosis. Many individuals go undiagnosed because symptoms can be misunderstood or dismissed, particularly in younger women.
Greater clarity around the condition could lead to earlier identification, more coordinated care and better long-term outcomes.
The new name also shifts focus away from fertility alone, which could reduce stigma, attract broader research funding, and accelerate progress in diagnosing, treating and ultimately preventing the condition, Vanden Brink added.
“For women, this is about more than a name,” Vanden Brink said. “It’s about recognizing the full scope of the condition so we can improve prevention, diagnosis and care.”
